This is a very serious situation with all the necessary triggers for eliciting a pulmonary hypertensive crisis, including hypoxia, oedema, anxiety, anaemia, hypovolaemia
Where clear markers of hypovolaemia
are present, colloids appear to be superior to crystalloids for initial resuscitation.
cardiac surgery, orthopaedic surgery or major gastrointestinal surgery) to critically ill patients with sepsis and hypovolaemia
Effective circulating fluid volume is decreased and hypovolaemia
and shock may develop.
13] Hypotension commonly results from hypovolaemia
and obstructive shock in trauma patients while positive pressure ventilation and excessive amounts of intravenous induction agents  have also been implicated.
and dehydration, causing peripheral vasoconstriction.
Sepsis-induced hypotension develops from general microcirculatory maldistribution of blood flow and blood volume, and from hypovolaemia
due to capillary leakage of intravascular fluid.
was therefore not an initiating factor for ARF.
Patients with septic shock release mediators which increase microvascular permeability and produce effusion of fluids and proteins to the interstitial space, causing hypovolaemia
, hypoproteinaemia, pulmonary oedema, peripheral oedema and multi-organ failure (1-3).
14) who concluded that, although hypovolaemia
and resultant hypotension are infrequently seen in children with severe malaria, impaired tissue perfusion shares features with sepsis syndrome and significantly contributed to deaths.
Hyperosmolar therapy with mannitol, by causing osmotic diuresis, may cause hypovolaemia
and result in episodes of arterial hypotension, which have been confirmed to significantly increase mortality in TBI patients (46-49).
Because of their altered physiological response to hypovolaemia
, children with haemodynamic instability do not present with typical adult clinical findings, and tachycardia, in the presence of a normal blood pressure, may be the only clinical sign of class III shock.